WHAT WE DO

Assessment

Patient care and your individual needs are at the centre of all treatments at Optimum. After taking a detailed history, I will carry out a thorough assessment to establish the cause of your condition. I will then work with you to develop a treatment programme which is tailored specifically to you and your underlying condition.

Treatments are for individual clients of all ages with conditions resulting from injury, infirmity or medical conditions such as:

Sports and work related injuries

Injury screening and prevention

Rehabilitation – from injury and surgery

Chronic Pain relief

Back Pain

Neck Pain

Sciatica

Repetitive strain injuries

Whiplash

Postural issues

Shoulder problems

Knee problems

Stress related conditions

Tension headaches

Joint strains

Tennis elbow

Golfer’s elbow

Ankle sprain

Treatments

I use a variety of techniques, ensuring that you are comfortable with them. These include:

Movement

Massage

Myofascial Techniques

Positional Release

Joint Mobilisations

Dry Needling

Kinesiology Taping

Exercises

How can Optimum help you?

I use a variety of techniques, ensuring that you are comfortable with them. These include:

Movement

Massage

Myofascial techniques

Positional release

Joint mobilisations

Dry needling

Exercises

Movement

Massage

Myofascial techniques

Positional release

Joint mobilisations

Dry needling

Exercises

Ongoing Care

A treatment is not simply one session, or a series of visits. Physical Therapy adopts a ‘big-picture’ or holistic approach. At Optimum I provide you with the knowledge and any necessary rehab plan that will allow as fast a recovery as possible and also to mitigate recurrence of injury.

So what does that mean in practice?

What it means is that I take into account any work or activity related issues which may be contributing to your condition. I will also take into account social and psychological issues which may also be contributing to your physical condition. I can also work with you to change activity patterns which may have contributed to your condition.

Call or contact me to find out more about the Treatments I provide

Massage Therapy

The benefits of massage therapy are extensive. It is estimated that up to 90% of disease is stress related and massage is an effective tool for managing stress, in the following ways:

Decreased anxiety

Enhanced sleep quality

Greater energy

Improved concentration

Increased circulation

Reduced fatigue

Decreased anxiety

Enhanced sleep quality

Greater energy

Improved concentration

Increased circulation

Reduced fatigue

Massage can also help manage or alleviate a number of other health issues, including:

Release endorphins (amino acids that work as the body’s natural painkillers)

Relieve migraine pain

Increase joint flexibility

Exercise and stretch weak, tight or atrophied muscles

Promote tissue regeneration and reduce scar tissue

Reduce post-surgery adhesions and swelling

Reduce spasms and cramping

Relax and soften injured, tired and overused muscles

Falls Prevention in Older Adults

Postural Stability Instructor with Later Life Training

The Postural Stability Instructor (PSI) qualification is based on a programme of exercises and support developed by Skelton & Dinan for a research intervention called FaME (Falls Management Exercise) in 1996-97.

The PSI course is evidence based and designed to equip health and exercise professionals with the knowledge and practical skills to deliver this proscriptive, progressive, individually tailored, postural stability programme to reduce falls risk factors in older people.

Qualified PSIs can teach all chair based FaME exercise (individual and group session) and the Otago (home based) exercise programme, both of which can reduce the risk of falls significantly.

The PSI qualification is the first and only evidence based accredited and endorsed falls prevention qualification. PSI is underpinned by current evidence (Cochrane Reviews, Sherrington Falls Exercise Review, NICE falls guidance, FaME programme, ProAct65+ study) and recommended by the Department of Health Prevention Package (2009), the RCP Audit of Falls Services (2012)and the Age UK Expert Series (2013) and ProFouND

Benefits of FaME - Physical

Reduced risk of falls

Improved strength & power

Improved balance & mobility

Improved asymmetry in limb function

Possible improvement in bone mineral density

Re-training floor skills to reduce the risk of a long lie following a fall

Improved confidence in balance

Reduced anxiety and fear

Increased activity and social interaction

Other Benefits of FaME

Following a fall there is an increased fear of falling which leads to reduced activity.

This in turn leads to decreased muscle strength, flexibility, balance and therefore an increased risk of falling again.

In order to stop this cycle, we aim to reduce the fear of falling by gradually and progressively reintroducing activity – beginning with chair based exercise.

The final stages of the exercise plans are to provide the participants with the strength and confidence to be actively able to get down to and up from the floor. I also introduce floor based activity so that if they do have a fall they have the techniques and strength available to either get up from the floor or to move on the floor to be able to reach a phone to call for help, thereby avoiding long lies.

FaME in Practice

So what does a FaME exercise programme entail? Well, in order to achieve the four main outcomes…

Improve balance and co-ordination

Increase Functional Capacity

Increase Bone and Muscle Mass

Increase Confidence (reduced fear of falling)

…there are 7 evidenced based activities:

Dynamic endurance training for balance

Dynamic balance training

Targeted resistance training (weights, bands and body weight) including targeted bone loading for leg and ankle strength, for arm and back strength

Backward chaining

Functional floor activities

Flexibility training for leg and ankle, chest and spine

Sustained, three dimensional adapted Tai Chi training

But remember…

Both individual and group sessions are tailored to each individuals ability and progressed according to their individual needs

There is a comprehensive referral and pre-participation screening process including measurable functional assessments which allow for ongoing monitoring of progress

I work with the individuals current medical and physiotherapy team to ensure the total wellbeing of every individual

Home exercise plan to be completed once or twice a week between supervised sessions.

Reassessment and exercise plan progression.

Dry Needling

Dry needling is a safe, effective treatment whereby a solid filament needle is applied directly to a trigger point – a tight band of tissue - in a muscle. This direct stimulation results in a mechanical and physiological resolution of the trigger point. Dry needling can produce the same effect as the injecting of a local anaesthetic to the area of the trigger point.

Technique

I identify a taut band or trigger point first by palpating the muscle.

I will then insert a needle directly into the taut band or trigger point that I have just located. This may elicit a local twitch response in the muscle.

Results

There are generally three patterns of pain relief that can occur following a dry needling treatment:

Pain relief immediately upon removal of the needle

Pain relief the next morning

Pain relief over a course of treatments

Local effect – needling stimulates never fibres in the skin and muscle which promotes healing

Central effect – other areas of the brain are influences – including the cerebral cortex and limbic system

Trigger points – trigger points are deactivated

How dry needling works

There are generally three patterns of pain relief that can occur following a dry needling treatment:

Possible side effects of dry needling

Dry needling is very safe. Serious side effects are very rare – less than one in 10,000 treatments. However, you should be aware of the following possible side effects:

Drowsiness after treatment in a small number of people, and, if affected you are advised not to drive

Minor bruising or bleeding occurs after needling in about 30% of treatments

Pain during treatment occurs during approximately 1% of treatment

Symptoms can get worse after treatment (approximately 3% of patients).

Fainting can occur in certain patients, particularly at the first session, but again this is very rare

Optimum Physical Therapy use only single use, sterile, disposable needles.

SPORTS PHYSICAL THERAPY

GAA Teams

Working with GAA teams involves both attendance at matches and individual treatments between games as needed.

At matches I see players for injury assessment, taping and strapping and warm up rubs before the game. During the match I assess any injuries that occur on the pitch and make a call with the management as to whether the player is fit to continue or not. Post match I give players advice on how to manage any bumps, bruises or injures that the sustained during the game. I also provide the players with advice and rehabilitation plans and exercises to aid their recovery.

Playing Camogie for my GAA club, Na Fianna, in Croke Park July 2013

Croke Park dressing room for the Dublin Premier Junior Camogie Team for their All Ireland Championship Final, September 2017

Working with Na Fianna Senior Camogie Team

Playing Camogie for my GAA club, Na Fianna, in Croke Park July 2013

Croke Park dressing room for the Dublin Premier Junior Camogie Team for their All Ireland Championship Final, September 2017

Working with Na Fianna Senior Camogie Team

Cycling

My role in cycling is formally called 'soigneur' but we are generally called 'swannys'. I am responsible for the riders wellbeing, both nutritional and physical. I prepare all the riders race food and beverages. I give the riders warm up rubs pre-race and I do recovery work with the riders each evening to ensure they are ready for the next days racing which includes their immediate post race food and additional food each evening to aid their post race recovery and ensure their nutritional need are being met.

Working with Nicolas Roche at the Road World Cycling Championships in Austria 2018

Team Ireland staff and riders at the Road World Cycling Championships in Austria 2018

With the riders and staff of the Irish team in Tour de L'Avenir 2017

A girl and a van - working with UCD Cycling Club in the Tour of Ulster 2018

UCD Team Ras Tailteann 2018

Waiting for the UCD riders to cross the finish line at Ras Tailteann 2018

If you are a team manager and require a physical therapist to support your team contact me on 086 8774819 or email dee@opt.ie, or fill out the contact form. Rates are available upon request.